Bill Tammeus writes about religion and ethics.

April 10, 2017

How to improve end-of-life care: 4-10-17

This past Friday here on the blog, I wrote about foolish efforts to extend human life indefinitely.

I suggested there that a better focus would be to accept the reality of our inevitable deaths, to provide excellent end-of-life care and to work to offer the opportunity for a healthful life with purpose.

Late last week I heard former Kansas Gov. Kathleen Sebelius, who was secretary of Health and Human Services in the Obama administration, speak about some of that when she addressed the annual awards dinner of the Center for Practical Bioethics here in Kansas City. (Before she spoke at the dinner, Sebelius had a chance to chat with former U.S. Rep. Dennis Moore and his wife, Stephanie, right, pictured here.)

Sebelius encouraged the 600 or so people in attendance to become acquainted with a recent report about end-of-life care that she helped shepherd through the Aspen Institute. She served as co-chair of the Aspen Health Strategy Group along with another former HHS secretary, Tommy Thompson.

I've linked you to the report ("Improving Care at the End of Life") in the previous paragraph, and I hope you'll give it a read in full. But for the blog today I want to highlight what the report calls "Five Big Ideas to Improve Care at the End Of Life." (Disclosure: One reason this subject interests me besides my journalistic focus on matters of theology and faith practices is that I serve on the board of Kansas City Hospice & Palliative Care, a non-profit agency that on any given day helps to care for up to about 400 people.)

Here are the Aspen group's five ideas, with a bit of commentary from me:

-- Build the development and updating of an advance care plan into the fabric of life. An advance directive, or living will, should be part of everyone's planning, just like a will to pass along one's valuables. And, in my view, faith communities should be providing regular opportunities for people to complete such plans and file them where they need to be.

-- Redefine Medicare coverage in a way that meets the complex needs of people with serious illnesses. Medicare now covers hospice care, but there are various levels of necessary health care people need before they choose to go into hospice care. The whole system should be seamless and well thought out. It's not now.

-- Develop a set of quality metrics related to end-of-life care that can be used for accountability, transparency, improvement and payment. Excellent hospices, such as KCH&PC, pay lots of attention to measuring the quality of the services they provide, but the truth is the variance in quality among hospices (especially the for-profit hospices) and home health services is wide. Patients need assurance that the health care organizations they turn to can be trusted to deliver care that meets high standards.

-- Increase the number and types of health professionals who can meet the growing needs of an aging population. In the grand scheme of things, geriatric and palliative care (not to mention hospice care itself) are relatively new disciplines in health care. And there often is a shortage of qualified professional to oversee such care. As the Aspen report itself notes about our aging population, "Each year 2.5 million Americans die. About 8 million people, or 2.5% of the U.S. population, have a serious illness or multiple chronic conditions and functional dependency as they approach the end of life." As things stand now, there aren't enough well-trained professionals to handle all this. And families also need help knowing how best to care for their elderly and ill who are still living at home.

-- Support model communities embracing fundamental change in the design and delivery of care for people with advanced illness. One hundred years ago, lots of the care of the elderly as they approached the end of life happened in a family setting in homes. But since World War II -- and especially since the first hospices opened in the 1960s and '70s -- a lot has changed. With that change we've often lost social and family structures that help. It's time to rethink all this.

The Aspen report is a lot more detailed than the brief highlights I've just given you. But I hope you will want to have a look at it and understand more deeply what needs to change when it comes to end-of-life care, and especially what role faith communities have in educating their members about all of this and in advocating necessary changes in government policy.

This stuff is too important to be left to chance or to a medical system interested more in profits than in compassionate care.

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UNDERSTANDING THE PROTESTANT REFORMATION

As I've mentioned more than once in recent posts, this year marks the 500th anniversary of the start of the Protestant Reformation. So I tend to pay attention when I see mention of this in the press. Which is how I happened to see this Dallas Morning News review of what looks like an intriguing new book, Protestants: The Faith That Made the Modern World, by Alec Ryrie. I liked the reviewer's comment about the book's subtitle: ". . .all one can really object to here is Professor Ryrie's subtitle. The faith that made the modern world? Please. Protestantism may have its historical sins of complicity and neglect, but, please. Let's not blame it for all this."

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About Me

Who is Bill?I'm the former Faith columnist for The Kansas City Star. For a more detailed bio, look under the "Check this out" headline below. My Twitter handle is @BillTammeus. Friend me on Facebook and you'll see this blog every day in your feed.